Salaries doubled over a 10-year period, but number of days worked, number of patients seen went down

Country doctor Dieter Baermann measures the blood pressure of Elisabeth Boehm in the patient's home on August 8, 2011 in Sachsendorf near Seelow, Germany. (Carsten Koall/Getty Images)

If you thought having well-paid doctors would translate into having better access to health care, a new study suggests you were mistaken.

While Quebec's doctors saw the total amount devoted to their salaries double over a 10-year period, the number of days they worked went down, as did the number of patients they saw.

Those are some of the findings of an independent study commissioned by Quebec's Health and Welfare Commissioner.

"The sustainability of the health care system is threatened by the level of investment in compensation, whereas in just about every sector there has been a drop in investment," said Damien Contandriopoulos, one of the researchers.

In 2006, the province's doctors were paid a total of $3.3 billion. That amount jumped to $6.6 billion by 2015, an average annual increase of about 8 per cent.

Meanwhile, by 2015, doctors were working an average of seven fewer days than they were in 2006 and were seeing about two fewer patients per day of work.

Damien Contandriopoulos says while the province has more doctors per capita than ever before, that isn’t translating to better access to care for patients because doctors are working less. (Radio-Canada)

The study's findings come a week after a group of doctors banded together to ask the government to cancel another planned raise for the province's doctors and spend the money on patient care and resources for their underpaid and overworked colleagues instead.

Across the province, nurses have been sharing their frustration with their work conditions, staging sit-ins and posting videos to social media.

Study presents picture of past, health minister says

Health Minister Gaétan Barrette said much of the information in the study isn't new and presents a picture of the past.

The Liberals introduced Bill 20, which put quotas on the minimum number of patients doctors have to see, in 2015.

"What's unfortunate is that the study doesn't go far enough to show the results of those changes," he told reporters in Montreal.

Speaking to reporters while on an economic mission in France, Premier Philippe Couillard said the study's findings justify his government's decision to pass that legislation.

He believes a key suggestion in the study — to overhault the way doctors are paid — contains an inherent contradiction.

"Payment on a fee-for-service basis, with all its faults, makes it so [doctors] want to see more patients. If we change the way [doctors] are paid so that there are fewer incentives to see more patients, we will add to the phenomenon" mentioned in the report, he said.

New agreements

The salary increases were the product of two separate deals which the government signed with the province's family doctors and its specialists in 2007.

Quebec specialists saw their annual salaries go from $335,003 in 2006 to $472,991 in 2015. General practitioners made $223,752 a year in 2006 and $281,053 in 2015.

"The amounts that were given to doctors were given to them under agreements that aimed to increase doctors' revenue. That was the goal, and that goal was met," said Contandriopoulos.

He said while the province has more doctors per capita than ever before, that isn't translating to better access because they are working less on an individual basis.

Deal was about money and nothing else, critic says

Jeff Begley, president of the CSN's health and social services federation, says he wasn't surprised by the findings.

The labour leader pointed out that Barrette, who was a radiologist, was the head of the specialists federation when the deal was signed.

That agreement, Begley said, was never about what services doctors had to provide to earn the increase. He echoed the notion that the deal was about money and nothing else.

"More and more people are saying 'enough is enough.' It has to be changed. This is one more brick in the wall to show that this reform has been a disaster," he said.​

Robert Salois served as the public health and welfare commissioner for 10 years. The job was created in 2006 by Couillard when he was health minister and abolished by Couillard's government 2016.

Robert Salois was the watchdog keeping an eye on policies enacted by Quebec's Health Ministry for 10 years, until his job was deemed unnecessary by the Couillard government and abolished in 2016. (Radio-Canada)

During his time in the position, Salois was known to be particularly critical of the governments with which he dealt.

Tasked with keeping an eye on the policies enacted by the province's Health Ministry, he said he dealt with pushback when he launched the study.

Salois said this generation of doctors has a different outlook on work and is focused on achieving a better work-life balance.

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